Mechanisms of Listening Effort in School Age Children who are Hard of Hearing

1篇摘要 2许多患有轻度至重度听力损失的儿童在很小的时候就被发现并接受早期干预。 3然而，即使有了这种早期干预，重听儿童（CHH）也会面临以下挑战： 4通信由于减少了对听觉信号的访问。这些挑战进一步加剧， 5所学校，因为CHH在不利的声学条件下感知言语的困难增加， 6听音条件的特点是声学效果差。当在不利条件下收听时，CHH必须发挥作用 与听力正常（CNH）的儿童相比，为了感知传入的声音， 8留言。因此，他们只有较少的认知资源来执行额外的任务， 9、增加倾听的努力。倾听的努力需要协调低层次的、自下而上的过程， 10和更高级别的自上而下的流程。目前还缺乏证据表明听觉和听觉之间的相互作用 11访问和更高层次的认知技能在影响个体差异的听力努力CHH。这 12知识差距阻碍了对驱动儿童倾听努力的潜在机制的理解 13听力损失，这反过来又限制了为这一人群制定循证干预措施的能力。的 14目前的建议旨在确定学龄CHH听力努力增加的因素。这 15建议是基于有限资源容量理论，假设听众需要额外的认知能力， 16资源，以保持最佳的听力性能，在不利的声学条件， 17资源导致次要任务的性能下降。具体而言，目前的提案测试了 18假设，自上而下的处理，量化的工作记忆和语言技能，是与 19学龄儿童CHH的听力努力，这种关系是由自下而上的处理，通过测量 20辅助听力。提出了两个具体目标来检验这一假设：目标1。为了确定更高- 21级认知语言技能对学龄重听儿童听力努力的影响，并评估 22听觉通路在多大程度上影响认知语言技能和听力之间的关系 23努力目标2.确定助听器使用和背景噪声对听力努力的影响， 24、听力不好在目标1中，工作记忆容量、接受性词汇量和辅助言语可听度将 25用于预测在不同背景噪声水平下的听力努力。在目标2中，CHH的倾听努力将是 26在辅助和无辅助条件下，在安静和背景噪声中进行评价。在这两个目标中， 27的倾听努力将被捕获，包括反应时间，自我报告措施和语音识别 28性能。从该提案中产生的数据将为关于以下方面的整合的理论模型提供信息： 29低层次的，声学语音输入和更高层次的，认知语言过程涉及听力，使用一个 30机械的方法来检查听力的努力。拟议的研究还将提供经验证据， 31在课堂和社会环境中为听力损失儿童制定有效的干预措施。

1 ABSTRACT 2 Many children with mild to severe hearing loss are identified and receive early intervention at very young ages. 3 Even with this early intervention, however, children who are hard of hearing (CHH) experience challenges with 4 communication due to reduced access to the auditory signal. These challenges are further compounded in 5 school because CHH have increased difficulty perceiving speech in adverse acoustic conditions and most 6 listening conditions are characterized by poor acoustics. When listening in adverse conditions, CHH must exert 7 additional cognitive resources compared to children with normal hearing (CNH) in order to perceive an incoming 8 message. Consequently, they have fewer cognitive resources available to perform additional tasks and must 9 expend increased listening effort. Listening effort requires the coordination of low-level, bottom-up processes, 10 and higher-level, top-down processes. There is a lack of evidence regarding the interplay between auditory 11 access and higher-level cognitive skills in influencing individual differences in listening effort for CHH. This 12 knowledge gap hinders the understanding of the underlying mechanisms that drive listening effort in children 13 with hearing loss, which in turn, limits the ability to develop evidence-based interventions for this population. The 14 current proposal seeks to determine the factors that underlie increased listening effort in school-age CHH. This 15 proposal is based on a limited resources capacity theory, which posits that listeners require additional cognitive 16 resources to maintain optimal listening performance during adverse acoustic conditions, and this demand on 17 resources results in a decline in performance on secondary tasks. Specifically, the current proposal tests the 18 hypothesis that top-down processing, quantified by working memory and linguistic skills, is associated with 19 listening effort in school-age CHH, and this relationship is moderated by bottom-up processing, measured via 20 aided audibility. Two specific aims are proposed to test this hypothesis: Aim 1. To determine the effect of higher- 21 level cognitive-linguistic skills on listening effort in school-age children who are hard of hearing, and to evaluate 22 the extent to which auditory access influences the relationship between cognitive-linguistic skills and listening 23 effort. Aim 2. To identify the effects of hearing aid use and background noise on listening effort in children who 24 are hard of hearing. In Aim 1, working memory capacity, receptive vocabulary, and aided speech audibility will 25 be used to predict listening effort in varying levels of background noise. In Aim 2, listening effort for CHH will be 26 evaluated in aided and unaided conditions, in quiet and in background noise. In both aims, different dimensions 27 of listening effort will be captured, including reaction time, self-report measures, and speech recognition 28 performance. The data generated from this proposal will inform theoretical models regarding the integration of 29 low-level, acoustic-phonetic input and higher-level, cognitive-linguistic processes involved in listening, using a 30 mechanistic approach to examine listening effort. The proposed study will also provide empirical evidence for the 31 development of effective interventions for children with hearing loss, in both classroom and social settings.